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Pituitary adenoma

Hasmet Yazici, Sedat Doğan, Mehmet Akif Sönmez, Olcay Eser
INTRODUCTION: Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery...
October 2016: Journal of Craniofacial Surgery
Bette K Kleinschmidt-DeMasters
PURPOSE OF REVIEW: Most pituitary region masses are pituitary adenomas; however, when other sellar region masses are encountered by clinicians or pathologists, the differential diagnosis can be broad. This review will focus on updates for pituitary adenomas, as well as briefly discuss some of these other entities: Rathke cleft cyst, hypophysitis, craniopharyngioma, pituicytoma, and spindle cell oncocytoma. RECENT FINDINGS: The use of new immunohistochemical (IHC) tools for assessing transcription factors, pituitary transcription factor-1, steroidogenic factor-1, and the not-yet-widely available Tpit IHC have provided insights into origin particularly of clinically silent and even hormone-negative pituitary adenomas...
October 18, 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
Thomas Gilliland, Sylvie Dufour, Gerald I Shulman, Kitt Falk Petersen, Sukru H Emre
NAFLD is a common condition linked to obesity, type 2 diabetes, and metabolic syndrome. Simple hepatic steatosis is a risk factor for inflammatory reactions in the liver (NASH), which may lead to cirrhosis. While the mechanism is unclear, NAFLD and NASH are associated with panhypopituitarism, which in the pediatric population often results from craniopharyngioma or pituitary adenoma and the sequelae of treatment, causing hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, and GH deficiency...
October 20, 2016: Pediatric Transplantation
J N Wang, L X Wang, W Lian, B Xing, Y Yao, M Feng, R Z Wang
Objective: To investigate the clinical characteristics and treatment of pituitary adenomas of childhood and adolescence. Methods: Thisarticle was a retrospective study of 140 pituitary adenomas of childhood and adolescence that was admitted into Peking Union Medical College Hospital from December 1987 to December 2014, whose clinical manifestations, hormone secretions, images, pathological types, surgical complications and follow-ups were studied. Results: A total of 58 (41.4%) males and 82 females (58.6%) were included, whose mean age was 12...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Chutintorn Sriphrapradang, Panudda Srichomkwun, Samuel Refetoff, Sunee Mamanasiri
We report a patient with resistance to thyroid hormone beta caused by a novel <i>THRB</i> gene mutation and coexisting pituitary microadenoma. A 41-year-old Thai woman presented with elevated serum thyroid hormone levels and non-suppressed TSH. MRI showed a 4x2-mm pituitary adenoma. Five of her relatives had similar thyroid tests abnormalities, but a sister had Graves' disease. TPO and TG antibodies were positive in all affected family members except for a 4.5 year-old. Lack of thyrotoxic symptoms and TSH suppression by T3, indicated incidentaloma rather than a TSH-secreting pituitary adenoma...
October 19, 2016: Thyroid: Official Journal of the American Thyroid Association
Kevin Phan, Joshua Xu, Rajesh Reddy, Piyush Kalakoti, Anil Nanda, Jacob Fairhall
BACKGROUND: The pituitary adenoma causing acromegaly is typically resected through a transsphenoidal approach and visualised with an operating microscope or endoscope. We undertook a systematic review and meta-analysis examining the clinical efficacy of endoscopic and microsurgical approaches. METHODS: Relevant studies using either endoscopic or microscopic transphenoid approaches for growth-hormone pituitary adenomas were identified up to Feb 2016. Data were extracted and analyzed according to predefined clinical endpoints...
October 15, 2016: World Neurosurgery
Liliya Rostomyan, Albert Beckers
Growth hormone (GH) secreting pituitary tumors may be caused by genetic abnormalities in a variety of genes including AIP, MEN1, CDKN1B, and PRKAR1A. These can lead to GH secreting pituitary adenomas as an isolated occurrence (e.g. as aggressive sporadic adenomas or in familial isolated pituitary adenomas (FIPA)) or as part of syndromic conditions such as MEN1 or Carney complex. These tumors have more aggressive features than sporadic acromegaly, including a younger age at disease onset and larger tumor size, and they can be challenging to manage...
October 12, 2016: Growth Hormone & IGF Research
Aruna Nambirajan, Mehar C Sharma, Madhu Rajeshwari, Aanchal Kakkar, Vaishali Suri, Chitra Sarkar
Ependymomas are gliomas that recapitulate normal ependymal cells. The epithelial membrane antigen (EMA) shows "dot-like" and "ring-like" staining patterns, highlighting "microlumens" or intracytoplasmic rosettes, a pathognomonic ultrastructural feature. NHERF1/EBP50, an adaptor protein localized at the apical plasma membrane of human epithelia, has been found to localize to these microlumens. We aimed to analyze the staining patterns of EMA and EBP50 in ependymomas and other tumors, and thereby compare their diagnostic utility...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Adomas Bunevicius, Sarunas Tamasauskas, Vytenis Pranas Deltuva, Arimantas Tamasauskas, Albertas Sliauzys, Robertas Bunevicius
BACKGROUND: The second-to-fourth digit ratio (2D:4D) reflects prenatal estrogen and testosterone exposure, and is established in utero. Sex steroids are implicated in development and progression of primary brain tumors. AIMS: To investigate whether there is a link between 2D:4D ratio and primary brain tumors, and age at presentation. METHODS: Digital images of the right and left palms of 85 primary brain tumor patients (age 56.96±13.68years; 71% women) and 106 (age 54...
October 14, 2016: Early Human Development
Patrizio Caturegli, Giulia Di Dalmazi, Martina Lombardi, Federica Grosso, H Benjamin Larman, Tatianna Larman, Giacomo Taverna, Mirco Cosottini, Isabella Lupi
Hypophysitis that develops in cancer patients treated with monoclonal antibodies blocking cytotoxic T-lymphocyte-associated protein 4 (CTLA-4; an inhibitory molecule classically expressed on T cells) is now reported at an incidence of approximately 10%. Its pathogenesis is unknown, in part because no pathological examination of the pituitary gland has been reported to date. We analyzed at autopsy the pituitary glands of six cancer patients treated with CTLA-4 blockade, one with clinical and pathological evidence of hypophysitis, one with mild lymphocytic infiltration in the pituitary gland but no clinical signs of hypophysitis, and four with normal pituitary structure and function...
October 14, 2016: American Journal of Pathology
June Yowtak, Suash Sharma, Scott E Forseen, Cargill H Alleyne
BACKGROUND: Mixed tumors of adenomatous and neuronal cells in the sellar region are an uncommon finding. The origins of these heterogeneous tumors are unknown and management of these lesions still debated. We report a very rare case of anterior gray matter pituicytic heterotopia with monomorphic anterior pituitary cells that likely represents a variant of non-secreting pituitary adenoma - neuronal choristoma (PANCH) without any ganglion cells. We also review the current literature for the different clinical presentations of PANCH...
October 12, 2016: World Neurosurgery
Donato Iacovazzo, Márta Korbonits
X-linked acrogigantism (XLAG) is a recently identified condition of early-onset GH excess resulting from the germline or somatic duplication of the GPR101 gene on chromosome Xq26.3. Thirty patients have been formally reported so far. The disease affects mostly females, occurs usually sporadically, and is characterised by early onset and marked overgrowth. Most patients present with concomitant hyperprolactinaemia. Histopathology shows pituitary hyperplasia or pituitary adenoma with or without associated hyperplasia...
September 29, 2016: Growth Hormone & IGF Research
Daniel S Olsson, Ing-Liss Bryngelsson, Oskar Ragnarsson
PURPOSE: Patients with non-functioning pituitary adenomas (NFPA), especially women, have increased mortality. The aim of this study was to investigate whether mortality in NFPA patients has changed during the last two decades. METHODS: This was a nationwide population-based study including 2795 patients (1502 men, 1293 women) diagnosed with NFPA between 1997 and 2011. Patients were identified and followed in Swedish National Health Registries. Standardized mortality ratios (SMRs) with 95 % confidence intervals were calculated for three time periods at first NFPA diagnosis using the general population as reference...
October 14, 2016: Pituitary
Francisca Caimari, Márta Korbonits
Recently, a number of novel genetic alterations have been identified that predispose individuals to pituitary adenomas. Clinically relevant pituitary adenomas are relatively common, present in 0.1% of the general population. They are mostly benign monoclonal neoplasms that arise from any of the five hormone-secreting cell types of the anterior lobe of the pituitary gland, and cause disease due to hormonal alterations and local space-occupying effects. The pathomechanism of pituitary adenomas includes alterations in cell-cycle regulation and growth factor signaling, which are mostly due to epigenetic changes; somatic and especially germline mutations occur more rarely...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Chikezie I Eseonu, Karim ReFaey, Jordina Rincon-Torroella, Oscar Garcia, Gary S Wand, Roberto Salvatori, Alfredo Quinones-Hinojosa
OBJECTIVE: The transition from microscopic to a fully endoscopic transsphenoidal surgery requires a surgeon to assess how the change in technique will affect the extent of tumor resection (EOR), outcomes, and complications. We compared a single surgeon's experience transitioning from one technique to the other, and examined the operative outcomes and EOR between microscopic versus endoscopic transsphenoidal surgery. METHODS: Retrospective data analysis of adult patients who were treated surgically for a pituitary adenoma between August 2005 and May 2015 by a single neurosurgeon, who was originally trained and practiced in the microscopic transsphenoidal approach...
October 11, 2016: World Neurosurgery
Mustafa Özçetin, Mehmet Karacı, Ertuğ Toroslu, Nurullah Edebali
Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apoplexy is defined as an acute clinical syndrome characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness...
September 2016: Türk Pediatri Arşivi
Man-Li Guo, Xiao Zheng, Liu-Xue Yang, Ya-Li Qiu, Liang Cheng, Shao-Gang Ma
Resistance to thyroid hormone (RTH) coexisting with ectopic thyroid is rare. Here we report a case of RTH with ectopic thyroid. A ten-year-old girl had been misdiagnosed as congenital hypothyroidism and treated with levothyroxine since she was born. Ten-year follow-up showed that the elevated thyrotropin was never suppressed by levothyroxine and no signs indicating hyperthyroidism or hypothyroidism despite elevated FT3 and FT4 levels. Therefore the girl developed no defects in physical and cognitive development...
October 10, 2016: Archives of Endocrinology and Metabolism
Karolína Drbalová, Kateřina Herdová, Petr Krejčí, Monika Nývltová, Svatopluk Solař, Lenka Vedralová, Pavel Záruba, David Netuka, Petr Bavor
Multiple Endocrine Neoplasia (MEN) is a condition in which several endocrine organs of an individual are affected by adenoma, hyperplasia and less often carcinoma, either simultaneously or at different stages of life. Two existing syndromes, MEN1 and MEN2 (2A, 2B), in literature is also mentioned MEN4, are associated also with other non-endocrine disorders. MEN1 (Wermer syndrome) affects the pituitary, parathyroid, and pancreatic area. 95 % of patients show very early manifestation of hyperparathyroidism, often before 40 years of age...
2016: Vnitr̆ní Lékar̆ství
Jana Ježková, Josef Marek
Adenomas which secrete thyrotropic hormone (thyrotropinomas) are rare and constitute less than 3 % of pituitary adenomas. In laboratory studies there is a typical elevation of thyroid hormones with nonsupressible TSH. In differential diagnostics it is necessary to distinguish above all the syndrome of resistance to thyroid hormones. Clinical symptoms are usually mild and correspond to symptoms of hyperthyroidism. Goiter is a common finding. In 80 % of cases thyrotropinomas are diagnosed in a stage of invasively growing macroadenoma...
2016: Vnitr̆ní Lékar̆ství
Benita Tamrazi, Melike Pekmezci, Mariam Aboian, Tarik Tihan, Christine M Glastonbury
RATIONALE AND OBJECTIVES: Pituitary macroadenomas are predominantly benign intracranial neoplasms that can be locally aggressive with invasion of adjacent structures. Biomarkers of aggressive behavior have been identified in the pathology literature, including the proliferative marker MIB-1. In the radiology literature, diffusion weighted imaging and low ADC values provide similar markers of aggressive behavior in brain tumors. The purpose of this study was to determine if there is a correlation between ADC and MIB-1 in pituitary macroadenomas...
October 12, 2016: Pituitary
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